Clinica Chimica Acta:对123名患者进行长期随访评价同型半胱氨酸再甲基化障碍和典型的同型半胱氨酸尿症

2020-07-19 MedSci原创 MedSci原创

同型半胱氨酸是由再甲基化缺陷和胱氨酸-合成酶(CBS)缺陷引起的,其特征是同型半胱氨酸升高和蛋氨酸异常水平。包括注射羟钴胺和口服甜菜碱各种治疗,目的是降低同型半胱氨酸毒性和使蛋氨酸正常化,但只很少评估

同型半胱氨酸是由再甲基化缺陷和胱氨酸-合成酶(CBS)缺陷引起的,其特征是同型半胱氨酸升高和蛋氨酸异常水平。包括注射羟钴胺和口服甜菜碱各种治疗,目的是降低同型半胱氨酸毒性和使蛋氨酸正常化,但只很少评估治疗的生化反应的生化数据。我们分析了56例再甲基化障碍患者和67例CBS缺乏症患者的812份血浆样本的实验室结果。

血浆总同型半胱氨酸(tHcys)随着治疗而降低,但无论采用何种治疗方法,均很少正常化,CBS(116±79μmol/ L)和MTHFR(102±56μmol/ L)缺陷水平最高。在CBS缺乏症中,tHcys与蛋氨酸呈正相关(rs = 0.51,p <0.0001),与胱氨酸成反比(rs = -0.57,p <0.0001)与高半胱氨酸下游的代谢阻滞相一致。在患有甲基化障碍的患者中,蛋氨酸在治疗时通常是正常的,并且与tHcys呈负相关(rs = -0.57,p <0.0001),表明羟基钴胺素和/或甜菜碱在刺激tHcys甲基化方面有效。甜菜碱也比其治疗前水平显着提高了肌氨酸水平,在再甲基化疾病中平均升高了19倍,而CBS缺乏症使肌氨酸升高了3倍,其中肌氨酸>> 5µμmol / L对甜菜碱治疗的敏感性为97%,特异性为95%。这些结果表明,现有的治疗方法改善了硫氨基酸代谢,但没有使其完全正常化,而肌氨酸可以决定补充甜菜碱的依从性。

原始出处:

IreneDe BiaseCarmenGherasimLaboratory evaluation of homocysteine remethylation disorders and classic homocystinuria: Long-term follow-up using a cohort of 123 patients

 

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    2020-09-25 windight
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    2020-08-06 147a7c89m10暂无昵称

    学习

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    2020-07-21 huagfeg
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    2020-07-19 医鸣惊人

    学习

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